Provider Demographics
NPI:1902273436
Name:FLOOD, JANET LYNN (RN)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LYNN
Last Name:FLOOD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ELM ST
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-2962
Mailing Address - Country:US
Mailing Address - Phone:631-335-0088
Mailing Address - Fax:631-285-3817
Practice Address - Street 1:15 ELM ST
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-2962
Practice Address - Country:US
Practice Address - Phone:631-335-0088
Practice Address - Fax:631-285-3817
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334812-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse